Journalistic media and adolescents in the COVID-19 pandemic: a documental analysis

ABSTRACT Objective: To analyze how the journalistic media has described the issues of quality of life (QoL), physical activity (PA) and mental health (MH) of adolescents during the COVID-19 pandemic. Methods: This is a descriptive and qualitative study that used content analysis. Sixty-two journalistic publications were analyzed from a total of 8211 published by the most read newspapers in each Brazilian region between December 2019 and August 2021. Results: The results were grouped and evaluated in three categories: QoL (n=11), PA (n =9) and MH (n=42). In the analyzed period, the adolescents had more time of exposure to screens, contributing to an inadequate diet, a decrease in PA and impairments in QoL. According to the media publications, the pandemic has also contributed to an increase in anxiety, depression, loneliness and fear resulting from the mental and emotional disorganization caused by the abrupt change in routine. Social vulnerability was presented as an aggravating factor in this context. The journalistic media did not pay the necessary attention to adolescents regarding the negative consequences of the pandemic on QoL, PA and MH. Conclusions: The analyzed reports showed that the pandemic caused a decrease in social interaction, feelings of uncertainty, fear and the appearance/exacerbation of symptoms of anxiety, stress and depression. Social vulnerability was presented as another obstacle to be faced in this problem.


INTRODUCTION
][3][4] The COVID-19 pandemic showed that adolescents did not present themselves as a more vulnerable group for infections by the SARS-CoV-2 virus; despite this, several factors linked to the pandemic have a direct negative influence on this population. 4Mental health (MH) stands out in this scenario and needs to be monitored in these young people with greater attention, given the concerns related to the transmissibility of the virus, uncertainties about the severity of the disease, the unpredictability regarding the duration of the pandemic and its consequences. 5ocial isolation was one of the most used strategic measures to control the spread of the virus, 4 but it had no intentional negative consequences for health, such as increased physical inactivity, anxiety and depression.In addition, it can worsen the mental state of adolescents with pre-existing psychiatric problems.Disorders resulting from MH and QoL in adolescents, if not identified and treated, can accompany the individual for a lifetime. 6,7he journalistic coverage of COVID-19 led to a daily approach to the topic in the media, contributing to the dissemination of scientifically based information. 1Faced with the phenomenon, the press sought to understand the facts and make them public.However, 1 no studies were found that evaluated adolescence in this context.
Communication media (television, radio, newspapers) are important means of spreading information and forming public opinion for society. 1 The media has the power to influence matters of interest, based on the information transmitted more regularly.This article aimed to analyze how the journalistic media has described the issues of QoL, PA and MH of adolescents facing the COVID-19 pandemic in Brazilian newspapers.

METHOD
This is a qualitative descriptive study using content analysis (CA). 8This research uses information in the public domain and is supported by resolution n. 510 of April 7, 2016 (Research Ethics Committee of the National Commission on Research Ethics -CEP/CONEP).
Bardin's CA 8,9 is structured in three phases: pre-analysis, material exploration, treatment of results and interpretation.To achieve national coverage, journalistic publications were selected from online databases of the three most read newspapers in each Brazilian region, according to the LatAm Journalism Review 10 (Table 1).The search strategy used the descriptors "adolescent" and "COVID-19".The inclusion criteria were articles published from December 2019 to August 2021 on the consequences of the COVID-19 pandemic on MH or QoL or PA in adolescents classified according to the World Health Organization (ten to 19 years old). 2 The excerpts selected to compose the analysis and discussion of the data were products obtained from the opinion of journalists and/or interviewees, as well as clippings from scientific texts and expert opinions.
The search and analysis of articles were conducted independently by two evaluators according to previously established strategies, with differences resolved by a third and fourth author and exported to Microsoft Excel 2010.Duplicate publications were identified and removed from the analysis.

RESULTS
From the cataloging of news (Figure 1), 62 journalistic publications were analyzed out of a total of 8211, which were divided into three categories of analysis.The first deals with reports related to QoL (n=11), where longer exposure time in front of screens and inadequate nutrition was identified.The second deals with PA (n=09) during the pandemic and it was observed that a sedentary lifestyle predominated during the pandemic period.In the third, the MH (n=42) of adolescents selected from social isolation was addressed, also addressing the psychological impacts affected by the adolescent public during the pandemic (Table 2, 3 and 4  The need to include a fourth category entitled pandemic and social vulnerability was identified.It was chosen considering that adolescents are represented in different ways in society.In this category, reports focused on the experience of the pandemic were identified, showing that the rich and poor do not experience the same effects of the pandemic.

Quality of life of adolescents during the pandemic
In this category, 11 journalistic stories were identified (Table 2) about the different changes in the lifestyles of Brazilian adolescents during social distancing resulting from the COVID-19 pandemic.The changes observed were an increase in the consumption of fast and unhealthy foods, a reduction in outdoor activities, reduced peer interaction and sedentary behavior.
QoL can be influenced by several factors and is related to aspects of health, self-esteem, relationships with family, friends, school and work.Adolescents who spent a large part of the day at school were restricted to the home environment full-time.In addition, social distancing may have had repercussions on family relationships, socialization and development. 9e research shows that families with young people aged 0 to 17 are more vulnerable during the pandemic in all scenarios analyzed and states that children and adolescents are "hidden victims of the pandemic".(Diário Gaúcho, Rio Grande do Sul, Brazil, 08/25/2020 -Study on obesity warns about children and adolescents in social distancing).
It is believed that social distancing was one of the most efficient measures to prevent the spread of the disease and reduce cases of COVID-19. 11However, it had direct repercussions on the adolescents' QoL.In this context, these adolescents' QoL may be compromised as they showed changes in eating, activity and sleep behavior in just three weeks of confinement. 9,11ith regard to education in times of a pandemic, few reports observed that adolescents considered school activities in remote teaching easy and found the classes very interesting, 9 as shown in an excerpt from the newspaper Correio (2021): "I was amazed by the boys, they participated a lot in the discipline, brought experiences that they had already had with reading a book and movie", and 73.3% of adolescents 9 showed concern and fear of getting low grades or failing the school year.This shows that technology, previously viewed as something that took the teenager out of social life, became increasingly used during isolation.
In the pandemic scenario, internet consumption has increased the digital sociability of this population, considering online classes and the maintenance of relationships through social networks, games and applications. 9Cell phones cannot be considered only as a source of entertainment, but as a tool that can help the educational process and virtual interaction with peers. 12Another issue to consider is that the predominance of screen time on electronic devices can cause dry eye syndrome or computer visual syndrome. 13In addition to classes on the computer, he plays with the tablet, with the cell phone.What we do is try to limit the use, but during the pandemic this is even more complicated".
Children following exactly the same patterns that I observed in the pre-pandemic period.(Zero Hora, Rio Grande do Sul, Brazil, 01/31/2021 -Games: the 'escape valve' for children and adolescents) The average time of screen exposure is longer than the recommended 4,12 and should not exceed two hours a day, 14 with educational content appropriate for the age group.This exposure is considered a risk factor for sedentary behavior, for cardiovascular and metabolic diseases. 4nother aspect observed was that the pandemic may have contributed to an inadequate diet.During the COVID-19 pandemic, there was a 13.26% increase in the consumption of ultra-processed foods 11 and a 48.58% increase in the consumption of frozen food, chocolates, sweets and packaged snacks. 4his may suggest that during the pandemic, adolescents, when staying at home, prefer to consume more frozen, fast, instant and industrialized foods, which may be related to their practicality and ease of preparation. 4,15ncern with the healthy development of children is constant, but this moment of greater seclusion, socializing and management of time and household tasks by adults, who started to work at home, often result in a certain "relaxation" of the family diet, with quicker and easier solutions, such as ordering delivery food or replacing one of the meals with a snack, pizza or something similar.(O Estado de São Paulo, São Paulo, Brazil, 07/23/2021 -Children's food worries families on vacation and during the pandemic).
On the other hand, about 8% of adolescents 16 stopped eating due to lack of money at home to buy food.The Programa Nacional de Alimentação Escolar (PNAE) 2 is considered the most comprehensive and successful public policy in force.Created between the 1940s and 50s, it offers meals to more than 40 million Brazilian students from the public school system. 17The food safety of these adolescents depends on school meals, as explained by the newspaper Zero Hora (2020): "We know that there are still children who go to school mainly to have access to food".
Brazilian school meals play a role of social protection, not only helping to eliminate hunger, but contributing to biopsychosocial growth and development, learning, school performance, as well as the formation of healthy eating practices, through food and nutrition education actions and the provision of meals that cover the nutritional needs of students during the period they remain in the school environment. 6All these practices were compromised during the pandemic and no policy to rescue these losses was directed to this population.

Physical activity during the pandemic
Since before the pandemic, diseases linked to obesity, physical inactivity and lack of PA were already on an upward curve in society. 11It is noteworthy that despite all the knowledge acquired about the benefits that the practice of PA provides and its relationship with the improvement of QoL and MH, 4 this subject was the least found in the initial search (n=09) (Table 3).Yet the need for confinement and social isolation, the limitations on circulation and PA suddenly imposed themselves on the lives of these adolescents. 17The reduction in PA practice and the increase in sedentary behavior among adolescents are also worrisome, given the association of these intervening factors with the risk of chronic diseases. 4,11In addition, most adolescents remained confined at home during the time of social distancing 4 without the presence of outdoor activities and lack of interaction with friends, thus resulting in a decrease in sports practices, in PA time and in a worsening of sedentary habits.
Obesity is a multifactorial disease that can cause multisystem complications and affect several organs. 17There is an excerpt where the journalist analyzes a published article exposing the danger of a sedentary child or adolescent being contaminated by the COVID-19 virus.
When obese children or adolescents are contaminated by SARS-CoV-2, these changes can complicate the situation, increasing the need for ventilatory support (when there is respiratory failure) and disrupting the immune response (defense of the body), among other possible events.(Diário Gaúcho, Rio Grande do Sul, Brazil, 08/13/2020 -Study on obesity warns about children and adolescents in social distancing).
The regular practice of PA combined with changes in eating habits and the adoption of a healthier lifestyle can help in the prevention and treatment of obesity. 17In adolescents, this practice has a direct influence on physical and bone development. 18,19On the other hand, sedentary behavior increases the chance of cardiovascular risk, decreases energy expenditure and is generally associated with the consumption of high-calorie foods and soft drinks, 20 in addition to having been shown to be a risk factor for adolescents who contracted COVID-19. 21

Mental health during the pandemic
Although MH was the category identified with the highest number of publications (n=42) (Table 4), it was observed over almost a year and a half of document analysis that much more could have been done for the health of adolescents in terms of journalistic coverage.There were reports of psychological suffering resulting from mental and emotional disorganization caused by the abrupt change in routine.
The COVID-19 pandemic, in addition to causing serious threats to the physical health of adolescents, 13,22 has also triggered a wide variety of psychological problems such as anxiety and depression.The reports reflect the effects of social isolation and the experience of the pandemic on the MH of adolescents: Social support is one of the factors that most protect against depression in adolescents.According to experts, teenagers that already have a mental disorder were even more affected by the lack of school attendance during the pandemic.(Zero Hora, Rio Grande do Sul, Brazil, 04/25/2021 -Young people face 'cage syndrome').
The more anxious our society is, the more anxious the future ones will be.What will the development and future of a child or adolescent for whom we do not preventively address mental health look like?How will we deal with the impacts of the "cage syndrome" (fear of going to school and leaving home) aggravated among teenagers due to the pandemic?(Folha de São Paulo, Brazil, 07/14/2021 -It is not a pandemic effect: mental health was already a public health problem and it is all of us).
The interruption of face-to-face school activities may be related to the anxiety rates found in adolescents. 15The school can act as a referral space for MH care services and also as a way to maintain routine habits, such as nutrition, for example, also functioning as an external support for adolescents in vulnerable situations. 23 is necessary to clarify that life will be resumed with changes.This return will also require an ability to adapt to a new reality, not least because we are no longer used to life before the pandemic.(O Globo, Rio de Janeiro, Brazil, 06/25/2020 -Depression increases among children and adolescents during the pandemic).
With the decrease in contact with the peer group, teenagers end up spending more time at home with feelings of loneliness and fear of the uncertainties of the pandemic.Associated with the worsening of psychological distress and social isolation, this may be associated with an increased prevalence of symptoms of post-traumatic stress disorder, 12 correlated with other mental symptoms being directly proportional to the amount of time in isolation: the longer the time, the greater the prevalence of symptoms consistent with psychological distress.
Extended isolation caused young people to withdraw for a long period from experiences that were intrinsic to their daily lives and to which they were already familiar.As a result, there was an increase in reports associated with heightened alert states, accompanied by some level of suffering.Anguish and avoidance in the face of new stimuli such as turning on the camera in online activities, complaints about fears that have already been overcome, infantilized behavior, excessive concerns regarding contamination by COVID-19 and resistance to returning to school can be reflections of a more intense state of anxiety (Folha, São Paulo, Brazil, 07/22/2021 -Mental health when returning to face-to-face classes).
Adolescents and young people will be able to feel the impact of the COVID-19 pandemic on their health for many years to come and, according to the results of an international survey of adolescents and young people, 20 one in five adolescents on average feels depressed or has little interest in doing things.This issue is directly related to the feeling of loneliness and distance from friends, the absence of professional counseling at student facilities, loss of freedom to come and go, concern for the future of the job market in which they will be inserted. 4,12dolescents with significant levels of anxiety and depression felt helpless with regard to care for their MH.][26][27]

Pandemic and social vulnerability
The closing of several services, including schools, has had a negative impact not only on the right to education but also on other human rights, such as the right to quality food promoted by school feeding programs. 16,28With the pandemic, it is known that this cruel reality was considerably accentuated, expanding the social asymmetries that had already plagued the Brazilian population since its formation.Meanwhile, in public schools, where there is a shortage of material and human resources, the number of students who gave up studying multiplied. 29e new coronavirus pandemic forced the suspension of face-to-face classes in schools around the world, which exacerbated inequalities among students.2018, according to UNESCO's 2020 Global Monitoring Report on Education.With the pandemic, inequality among students has worsened (Correio Braziliense, Distrito Federal, Brazil, 03/26/2020 -Unesco: pandemic exacerbates the exclusion of children and young people to education in the world).
Among the different reasons for a disconnection from studies is the fact that many adolescents need to contribute to the family income and others do not have access to technological resources, which makes it impossible to monitor remote classes. 14In addition to this, millions of students, despite being regularly enrolled, did not receive guidance or were not able to adapt to carrying out school activities on their own in the distance modality. 16This inequality that underpins Brazilian society became more evident during the pandemic and the inequalities and differences between economic classes became prominent in the country to the point where we have a school dropout rate of 12% in the adolescent population. 3d it's not just work that many have had to give up, education is another field of abandonment.Young girls and adolescents, mostly black and from poor suburbs, had to leave schools to help at home.Housework is still one of the main goals for women.According to data from the Continuous National Household Sample Survey (Continuous Pnad), there are 7 million women who have returned to domestic work -which does not exist.A brutal throwback to decades of advancement.(Folha, São Paulo, Brazil, 05/03/2021, The pandemic impacts maternal mental health and signs of stress and depression).
These adolescents are social actors represented and capable of identifying how reality impacts their lives and those of other people around them, thus building their own representations and narratives. 30Social representations are sets of practical knowledge of everyday life, collectively constructed from day-to-day challenges, imposed by phenomena that cause strangeness to subjects, altering their ways of thinking, feeling and acting. 30espite identifying a situation of alert given the low social interest by the adolescent public expressed by the journalistic media, this research did not evaluate the long-term effect that exposure to isolation and its consequences can cause; in addition, document analysis should be used with caution in possible generalizations.Another possible limitation was the small number of publications found, as communication media did not pay due attention to the negative impact the COVID-19 pandemic had on the health of adolescents.However, the richness and complexity of the topic opens up future possibilities for continuity or expansion of different points of view.The results described here can support policies and strategies that are able to deal with priorities, but without the detriment of others.Pandemics and catastrophes can occur, but assistance plans for all populations can and must be developed to try to minimize any health problems.
In an expanded view, studies on communication, the media and health are necessary in order to foster a greater discussion around how information circulates and is appropriated by different audiences.The fact that adolescents do not present themselves as a mortality risk group contributed to this audience being placed in the background of media attention.It is important to debate what kind of news the population had access to during the COVID-19 pandemic and how this reflects, or not, the reality of that moment.It is in this context that studies such as this one can contribute to the area of public health and, specifically, adolescent health.
The authors conclude that the communication media did not adequately address the negative consequences that the COVID-19 pandemic had on the QoL, PA and MH of adolescents during the pandemic period, more specifically between 2020 and 2021.Of eight thousand publications that were related to adolescents and COVID-19, only 3% were about QoL, PA and MH.The newspapers viewed teenagers as excluded in the pandemic, with regard to journalistic priorities.The analyzed reports showed that the pandemic intensified the adolescents' weaknesses, causing a decrease in social interaction, feelings of uncertainty, fear and the appearance/exacerbation of symptoms of anxiety, stress and depression.Social vulnerability was presented as another obstacle to be faced in this problem.In this sense, with the advancement of studies on and the understanding of long-term symptoms related to the disease, it is essential to continue research on this subject not only in health studies, but also in studies focusing on how to communicate and inform such issues.
The situation became more critical during the COVID-19 pandemic.Social isolation reduced physical activities, especially those done in groups.Time dedicated to sedentary activities, such as video games, cell phones and other screens, have become the only option for fun for most.(O Liberal, Pará, Brazil, 08/01/2021 -5 to 8% of children and adolescents in Pará are obese).

Table 1 .
10 Mapping of the three most read newspapers in the Brazilian Regions.10 Figure 1.Flowchart of the selection of journalistic publications.

Table 2 .
Characterization of journalistic articles about quality of life in adolescents.

Table 3 .
Characterization of journalistic articles about physical activity level in adolescents.
PAL: Physical Activity Level.

Table 4 .
Characterization of journalistic articles about mental health in adolescents.
SM: Mental Health.